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Benefiting from the government CERT audits
Marilyn Hammon1, Willy E Hammon
1University of Oklahoma Health Science Center, Oklahoma City, USA.
Abstract:
In order to minimize the risk of submitting improper or false claims, one important component of a compliance program is performing medical chart audits to make certain that all of the essential elements of the billed codes are present in the physician's documentation. The federal government has a program know as the Comprehensive Error Rate Testing (CERT) program which is responsible for auditing the frequency of errors committed by 1) Medicare providers and 2) Medicare carriers and then publishing those results in a report. The CERT report can be a useful guide for auditing charts because it identifies areas that have been particularly problematic and are more likely to be closely scrutinized by governmental auditors.
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